Background Treat to Target (T2T) strategy becomes from the need to develop therapeutic targets and tools to achieve defined outcomes in rheumatoid arthritis (RA), this strategy has become recognized as a standard of good practice embodying the principle that rapid attainment of remission, or low disease activity, can halt joint damage and maintain good quality of life.
Objectives The aim of this study was to describe global change in Disease Activity Score 28 (DAS28) using T2T strategy for a 5 year period in patients with conventional DMARD therapy in a large cohort of patients from a Colombian specialized in RA center with multidisciplinary care model (MCM).
Methods A descriptive dynamic cohort study was performed. Records of patients using conventional DMARD treatment from specialized in RA center were reviewed; those patients were followed-up under T2T standards. Clinical follow-up was according to DAS28 as follows: every 3–5 weeks (DAS28 >5.1), every 7–9 weeks (DAS28 ≥3.1 and ≤5.1), and every 11–13 weeks (DAS28 <3.1). Therapy had to be adjusted with DAS28 >3.2 unless patient's conditions don't permit it. MCM model means that every patient is seen by the other specialties involved in care as a minimum three times a year. We divided patients in three groups: low disease activity (LDA), moderate disease activity (MDA) and severe disease activity (SDA) patients. Descriptive epidemiology was done, percentages and averages were calculated; the median of each variable was analyzed using t-Student assuming normality for DAS28 distribution and the level activity disease was analyzed using Pearson's statistics.
Results We included 1443 patients, 84% were women and 16% were men. Mean age was 62±11 years; mean DAS28 at beginning was 4.0±1; regarding disease activity 57% were in moderate disease activity and 17% in severe disease activity. While at 5 year follow up mean DAS was 2.92±0.65, 48% achieved remission, 30% low disease activity, with decrease to 20% in moderate disease activity and 2% in severe disease activity.
Conclusions There is a significant improvement of DAS28 in a cohort of RA patients receiving only conventional DMARDs therapy, treated and followed under T2T strategy recommendations and a MCM model.
Disclosure of Interest None declared